Hutt Erika, Vega Brizneda Maria P, Jellis Christine L, Neto Manuel L Ribeiro, Jaber Wael A, Cremer Paul C
Department of Cardiovascular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
EJNMMI Rep. 2024 Oct 1;8(1):31. doi: 10.1186/s41824-024-00218-4.
Current diagnostic criteria for cardiac sarcoidosis (CS) rely on non-invasive imaging tools including positron emission tomography (PET-CT) and cardiac magnetic resonance (CMR). The aim of this study was to assess the prevalence of discordant myocardial inflammation between PET-CT and CMR in patients with known cardiac sarcoidosis. We retrospectively identified patients with both F-FDG PET-CT and CMR who had histology-proven sarcoidosis (N = 148). Among these 25 (17%) had abnormal F-FDG metabolism with normal tissue characterization by CMR. Of these, 13 (9%) had the studies concomitantly within 180 days (median 5 days, IQR 1-31). During median follow up of 7 years, 3 (23%) deaths were documented. Although prospective studies are required to address the best imaging approach for cardiac inflammation, our observation that some patients with CS have evidence of disease activity on PET-CT, but not on limited CMR without mapping suggests that a negative limited CMR may not fully exclude CS.
目前心脏结节病（CS）的诊断标准依赖于正电子发射断层扫描（PET-CT）和心脏磁共振成像（CMR）等非侵入性成像工具。本研究的目的是评估已知心脏结节病患者中PET-CT与CMR之间心肌炎症不一致的患病率。我们回顾性地确定了同时接受F-FDG PET-CT和CMR检查且经组织学证实为结节病的患者（N = 148）。其中25例（17%）F-FDG代谢异常，但CMR显示组织特征正常。在这些患者中，13例（9%）在180天内同时进行了这两项检查（中位时间为5天，四分位间距为1 - 31天）。在中位随访7年期间，记录到3例（23%）死亡。尽管需要进行前瞻性研究以确定心脏炎症的最佳成像方法，但我们观察到一些CS患者在PET-CT上有疾病活动的证据，但在未进行心肌灌注成像的有限CMR检查中却没有，这表明CMR检查结果为阴性可能无法完全排除CS。
